Breathe Like Your Life Depends On It (Because It Does)

My wife recently completed over a year of rigorous yoga teacher training.

She's deeply immersed in ancient yogic wisdom—naturally, I've become an involuntary student at home.

One evening, she looked at me and said, "Your breathing could benefit from some work."

I laughed at first. Breathing? I've been doing it all my life. I've read about breathing techniques mostly related to improving athletic performance.

But as she explained the practice of Pranayama, I realized there's an entire science behind something I took for granted. Also, by the way, yoga has much more to do with breathing than stretching and bending your body in sophisticated poses.

Controlled breathing has been studied and refined for thousands of years—its origins and related concepts date back at least 2,500 to 3,000 years.

Reason enough to explore breathing in more depth in this newsletter.

The mortality data that should shock you

Everyone has an opinion about cardio, strength training, and nutrition. Everyone obsesses over the latest longevity supplement, peptide, or wearable. But here's the truth: most people have no idea how something as fundamental as breathing impacts their lifespan.

The evidence is stark. People with severe sleep apnea—a condition where breathing repeatedly stops and restarts during sleep—have over 3 times the risk of all-cause death compared to those without it. When researchers excluded those treating it, the mortality risk jumped even higher (hazard ratio 4.3).

Let that sink in. Poor breathing at night is killing people faster than many diseases we actively screen for.

And it's not just sleep apnea. The way you breathe throughout your day—through your mouth or nose, fast or slow, shallow or deep—is silently determining your health trajectory. If you're waiting for breathing problems to announce themselves with flashing warning signs, you'll be waiting a long time. When you notice symptoms, your breathing patterns have likely compromised your health for years.

You can pop all the metformin and NMN you want (more on that in another edition). Still, you undermine everything else if you're chronically hyperventilating through your mouth.

The nitric oxide miracle you're bypassing

Breathing through your nose isn't just a preference—it's a biological imperative.

When you inhale through your nose, something remarkable happens that mouth breathing simply cannot replicate: nitric oxide gets released from your nasal passages. This molecule, discovered by Louis Ignarro (who won a Nobel Prize for his work), transforms your circulation.

Nitric oxide is a vasodilator that opens up your blood vessels, improves oxygen delivery, regulates blood pressure, and exhibits antiviral and antibacterial properties. In his book Breath, James Nestor calls nasal breathing a "superpower" we've forgotten how to use.

The benefits aren't theoretical. When you switch from mouth to nasal breathing, you get:

• 15-20% more oxygen uptake
• Improved heart rate variability
• Better filtration of airborne particles
• Enhanced humidification of incoming air
• Protection against respiratory infections

Elite athletes figured this out years ago. Some runners and cyclists now train exclusively with nasal breathing. After adaptation, they maintain the same performance levels while breathing more efficiently—and with less stress on their bodies.

"Nasal breathing is like using a premium fuel in your car," writes Patrick McKeown in The Oxygen Advantage. "Mouth breathing is like contaminated fuel that gradually destroys your engine."

McKeown's work builds on the foundation laid by Dr. Konstantin Buteyko, a Ukrainian physician who, in the 1950s, developed a breathing methodology after observing that many health conditions improved when patients normalized their breathing patterns. His core insight—that chronic overbreathing (hyperventilation) contributed to numerous health problems—became the basis for breathing techniques now used worldwide.

The ultimate stress circuit breaker

Everyone talks about stress management. Meditation apps. Yoga retreats. Digital detoxes. All useful. But nobody tells you that most stress management tools work through the exact fundamental mechanism—they change how you breathe.

Your breathing pattern is the fastest direct input to your nervous system. It's the remote control for your stress response.

Think about it. When you're anxious or panicked, your breathing becomes shallow, rapid, and irregular—usually through your mouth. This pattern sends immediate signals to your brain: danger. Your sympathetic "fight or flight" system activates, cortisol floods your system, and your capacity for clear thinking plummets.

Intentionally shifting your breathing pattern interrupts this cascade. Within 90 seconds of slow, controlled breathing, your parasympathetic system begins to counterbalance the stress response. Heart rate decreases. Blood pressure drops. Stress hormones decline. Brain wave patterns shift toward a calmer alpha state.

A 2023 Stanford study compared different 5-minute daily breath practices against mindfulness meditation in stressed adults. After one month, the breathwork groups showed more significant improvements in mood and anxiety than the meditation group. Exhale-focused breathing (cyclic sighing) proved most effective at reducing subjective stress and objective physiological markers of stress.

This isn't just subjective—it's measurable. Heart rate variability (HRV), a key autonomic nervous system health marker, increases substantially during slow, controlled breathing. Higher HRV correlates with greater stress resilience, better recovery, and even longer lifespan.

I've been experimenting with some of these techniques as part of my ongoing research. Preliminary self-data suggests an impact—my resting HRV has shown improvement since implementing regular breath work. I've been tracking the difference in stress recovery—situations that would have previously triggered a prolonged stress response now appear to cause just a brief spike before returning to baseline. However, like any n=1 experiment, more data is needed.

The sleep-breath cycle: the nighttime determinant of daytime performance

Quality sleep isn't just about duration—it's about how you breathe during those hours.

During sleep, your breathing should be deep and regular, providing ample oxygen and creating a calm rhythm for restorative processes. When breathing goes awry at night—whether from sleep apnea, mouth breathing, or irregular patterns—it shatters sleep architecture.

The consequences are severe. Disrupted nighttime breathing leads to:

• Reduced deep sleep and REM
• Elevated nighttime blood pressure
• Increased stress hormone production
• Impaired memory consolidation
• Compromised cognitive performance the next day

This explains why addressing breathing during sleep delivers results that can seem miraculous. A 2020 study demonstrated that non-forced deep breathing cycles before bed significantly improved multiple sleep parameters, including overall sleep quality, time in bed, and total sleep time. It also significantly reduced sleep latency and the percentage of awake time during sleep.

Even without sleep disorders, optimizing your breathing before and during sleep might be the most underrated performance hack.

Wim Hof, famous for his cold exposure methods, emphasizes specific breathing techniques as preparation for better sleep. "Breathing is the forgotten pillar of health," he notes in The Wim Hof Method. "We focus on food, exercise, sleep, but rarely on the way we breathe—even though we do it 25,000 times a day."

The elite athlete secret: respiratory muscle training

Beyond breathing techniques, there's another frontier that cutting-edge performers are exploring: directly training the muscles involved in respiration.

Your diaphragm and intercostal muscles are just that—muscles. They can be strengthened, conditioned, and improved like any other muscle group. When these muscles fatigue during prolonged exertion, they trigger what's called the metaboreflex—redirecting blood flow away from working limbs to support the increased oxygen demands of respiratory muscles.

I've been experimenting with a Buteyko belt during some training sessions. This simple device restricts abdominal movement and forces deeper diaphragmatic engagement. It's uncomfortable, but the impact on breathing awareness is immediate. Similarly, I've tested breath resistance masks during workouts. While the science of these devices is still evolving, the principle makes sense: systematic respiratory muscle training delays the fatigue threshold.

These approaches are expanding endurance capacity through improved ventilatory efficiency. The benefits extend beyond just athletic performance:

• Improved recovery between intense efforts
• Enhanced oxygen delivery to working tissues
• Reduced perception of breathlessness
• Better maintenance of proper posture and core stability
• Defense against respiratory muscle fatigue in aging

Even if you're not an elite athlete, respiratory muscle training can transform how you feel during everyday activities and stressful situations. When your breathing capacity exceeds your daily demands, you have a physiological reserve that shows up as better stress tolerance and cognitive clarity.

A breathing protocol worth more than your premium supplements

I'm not against supplements. But before you spend hundreds on the latest longevity stack, consider this free, scientifically validated breathing protocol:

1. Commit to nasal breathing 24/7. Tape your mouth at night if needed (yes, it sounds extreme, but it works—I've been testing this approach for several months now).
2. Practice "resonance breathing" daily: 5.5-6 breaths per minute (inhale for 5, exhale for 5) for at least 5 minutes. This maximizes heart rate variability and autonomic nervous system balance.
3. Before high-pressure situations, use the 4-7-8 technique: inhale for 4, hold for 7, exhale for 8. Studies show this pattern rapidly reduces stress and improves decision-making.
4. Train your CO2 tolerance with simple breath holds: after a normal exhale, hold your breath until slightly uncomfortable, then resume normal breathing for 30 seconds. Repeat 5-10 times.
5. During exercise, focus on breathing through your nose as much as possible. If you must mouth breathe, do so with control rather than gasping.

If you're skeptical, track your HRV, sleep quality, and stress levels for two weeks while implementing this protocol. The data will speak for itself.

Here's the paradox: the more you can slow and control your breathing in daily life, the better your body will handle high-intensity demands when necessary. Respiratory flexibility—not just maximum capacity—is the goal.

What’s next for me?

So, when my birthday rolled around a few weeks ago, what did my wife get me? Another gadget? Some fancy supplement? Nope. She went straight for the foundation—a session with an expert breath coach.

It's happening this Saturday—from Pranayama sceptic to breath work client in just a few months. Life comes at you fast.

The truth is, we've engineered breathing out of modern life. We've climate-controlled, desk-chained, stress-filled, and mouth-breathed ourselves into a physiological corner. And no amount of biohacking or supplementation can compensate for getting the fundamentals wrong.

Fix your breathing, and you might need less of everything else. Fewer supplements. Less caffeine. Reduced recovery time. Better sleep without the aids.

After all, you'll do it roughly 25,000 times today, whether you think about it or not. Might as well get it right.

I'll let you know how it goes. Hopefully, I'll have something more profound to report than "breathing is important." But honestly? Sometimes, the most straightforward insights are the most transformative.

Stay healthy.

Andre

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A note for new readers:

I’m a trained reconstructive facial surgeon, medical doctor, and dentist by training. Before launching my newsletter, I had a varied career: I was a competitive freestyle wrestler, a management consultant (McKinsey), an entrepreneur (Zocdoc, Thermondo, and docdre ventures), and a corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.

If this is your first time here, welcome. I’m excited to share what I’ve learned—and will continue to learn—with you.

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DISCLAIMER:

Let’s get one thing straight: None of this—whether text, graphics, images, or anything else—is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.

Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.

If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in Health, Redefined. Be smart. Do your research. And, as always, take care of yourself.